國家衛生研究院 NHRI:Item 3990099045/15434

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Title:	Whose osteoporosis should be treated among long-term care residents?
Authors:	Fu, SH;Hung, CC;Yang, RS;Wu, CH;Li, CY;Wang, CY
Contributors:	National Center for Geriatrics and Welfare Research
Abstract:	Objective: Previous studies revealed very high prevalence of osteoporosis from 59 * 92% among women and 34.4 * 79.6% among men at different age distribution among long-term care residents (LTCRs). And the incidence of hip fracture remained unacceptably high and were 3- to 10-fold greater than the incidence of similar age community dwellers. However, it is very difﬁcult to determine whose osteoporosis should be treated after considering the fracture risk, mortality, onset time of anti-osteoporosis medications (AOMs) in this population. The onset time of most ﬁrst-line anti-resorptive medication was at least one year. We aimed to ﬁnd important factors that related to fracture and survival for more than one year to solve these complex problems. Methods: This was a prospective cohort study with a follow-up period of three years. We prospectively enrolled 785 older residents aged C 50 years old from 20 long-term care facilities. At baseline, we collect age, sex, BMI, activities of daily living (Barthel index), alcohol and smoking status, comorbidities, previous fracture history, parental history of fracture, age at menopause, fall history, information related to osteoporosis, and followed their clinical fracture and death. We categorised the residents into two groups: (1) those who would survive for more than 1 year and fractured; (2) others. Logistic regression was then applied to ﬁnd out the risk factors that related to group 1. Results: 785 LTCRs consented to screening from October 2018 to November 2019 in Yunlin County, Taiwan and followed up to June 2022. Of them, 338 were men and 447 were women with mean ages of 75.6 and 81.2 years, respectively. Most participants were severely dependent for their everyday physical activity, with a mean Barthel index of 28.6; and 44.1% were categorized as bedridden. 648 LTCRs could be followed till fracture, death, or for 2 years, with the follow-up rate 82.5%. The incidence of all fracture of LTCRs was 13.1 per 1000 PYs and the hip fracture incidence was 6.6 per 1000 PYs. The mortality rate was estimated at 172.7 per 1000 PYs. Some important factors were related to fracture and survival for more than one year, such as female gender, good activity of daily living function, Parkinsonism, and previous fracture history. Conclusion: Good daily activity was positively related to fracture risk and negatively related to mortality of LTCRs. Other risk factors, such as female gender, Parkinsonism, and previous fracture history also signiﬁcantly related to fracture and survival for more than 1 year. LTCRs with these factors would be the candidate of AOMs treatment.
Date:	2023-07-21
Relation:	Aging Clinical and Experimental Research. 2023 Jul 21;35:S166.
Link to:	http://dx.doi.org/10.1007/s40520-023-02442-7
JIF/Ranking 2023:	http://gateway.webofknowledge.com/gateway/Gateway.cgi?GWVersion=2&SrcAuth=NHRI&SrcApp=NHRI_IR&KeyISSN=1594-0667&DestApp=IC2JCR
Cited Times(WOS):	https://www.webofscience.com/wos/woscc/full-record/WOS:001058500201071
Appears in Collections:	[Chen-Yu Wang] Conference Papers/Meeting Abstract

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